Individual
ANA PAULA GORGOLL FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1231 SW 110TH AVE, PEMBROKE PINES, FL 33025-3513
(754) 244-2541
Mailing address
1231 SW 110TH AVE, PEMBROKE PINES, FL 33025-3513
(754) 244-2541
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
23-302168
FL
Other
Enumeration date
11/29/2023
Last updated
11/29/2023
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